使用体外膜氧合的小儿血液病和肿瘤患者:2009-2021年多中心、回顾性队列的结果。

IF 4 2区 医学 Q1 CRITICAL CARE MEDICINE Pediatric Critical Care Medicine Pub Date : 2024-11-01 Epub Date: 2024-07-19 DOI:10.1097/PCC.0000000000003584
Michael Colin Mowrer, Lisa Lima, Rohit Nair, Xilong Li, Hitesh Sandhu, Brian Bridges, Ryan P Barbaro, Saleh Bhar, Raymond Nkwantabisa, Saad Ghafoor, Agnes Reschke, Taylor Olson, Matthew P Malone, Neel Shah, Matt S Zinter, Jon Gehlbach, Laura Hollinger, Briana L Scott, Reut Kassif Lerner, Thomas V Brogan, Lakshmi Raman, Renee M Potera
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引用次数: 0

摘要

目的描述与肿瘤诊断或体外膜氧合(ECMO)支持造血细胞移植(HCT)的儿科患者存活率相关的特征:设计:多中心、回顾性研究:背景:美国和以色列的 16 个 PICU:我们纳入了年龄小于 19 岁、在 2009 年至 2021 年期间需要 ECMO 支持的肿瘤诊断或 HCT 患者:无干预措施:共有 149 名患者被纳入研究队列。其中 118 名患者接受了肿瘤诊断,31 名患者接受了 HCT。ECMO 的适应症为呼吸衰竭(46%)、合并呼吸衰竭和心力衰竭(28%)以及心力衰竭(25%)。45%的患者使用静脉(V-V)ECMO,53%的患者使用静脉动脉(V-A)ECMO。就肿瘤组和 HCT 组而言,ECMO 拔管后的存活率分别为 52%(62/118)和 64%(20/31),出院后的存活率分别为 36%(43/118)和 42%(13/31)。在调整了其他因素后,需要心肺复苏与更大的死亡几率相关(3.0 [95% CI, 1.2-7.7]):本研究中,儿科肿瘤和 HCT 患者从 ECMO 解除到出院的存活率为 52-64%,具体取决于诊断。然而,出院后的存活率仍然很低。未来的研究应优先了解造成这些患者群体生存率差距的因素。
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Pediatric Hematology and Oncology Patients on Extracorporeal Membrane Oxygenation: Outcomes in a Multicenter, Retrospective Cohort, 2009-2021.

Objective: To describe characteristics associated with survival for pediatric patients with an oncologic diagnosis or hematopoietic cell transplant (HCT) supported with extracorporeal membrane oxygenation (ECMO).

Design: Multicenter, retrospective study.

Setting: Sixteen PICUs in the United States and Israel.

Patients: We included patients aged younger than 19 years with an oncologic diagnosis or HCT who required ECMO support between 2009 and 2021.

Interventions: None.

Measurements and main results: A total of 149 patients were included in the study cohort. There were 118 patients with an oncologic diagnosis and 31 that received HCT. The indications for ECMO were respiratory failure (46%), combined respiratory and cardiac failure (28%), and cardiac failure (25%). Venovenous (V-V) ECMO was used in 45% of patients, with 53% of patients being placed on venoarterial (V-A) ECMO. For oncologic and HCT groups, survival to ECMO decannulation was 52% (62/118) and 64% (20/31), and survival to hospital discharge was 36% (43/118) and 42% (13/31), respectively. After adjusting for other factors, requiring cardiopulmonary resuscitation was associated with greater odds ratio of mortality (3.0 [95% CI, 1.2-7.7]).

Conclusions: Survival to ECMO decannulation of pediatric oncologic and HCT patients in this study was 52-64%, depending upon diagnosis. However, survival to hospital discharge remains poor. Future research should prioritize understanding factors contributing to this survival gap within these patient populations.

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来源期刊
Pediatric Critical Care Medicine
Pediatric Critical Care Medicine 医学-危重病医学
CiteScore
7.40
自引率
14.60%
发文量
991
审稿时长
3-8 weeks
期刊介绍: Pediatric Critical Care Medicine is written for the entire critical care team: pediatricians, neonatologists, respiratory therapists, nurses, and others who deal with pediatric patients who are critically ill or injured. International in scope, with editorial board members and contributors from around the world, the Journal includes a full range of scientific content, including clinical articles, scientific investigations, solicited reviews, and abstracts from pediatric critical care meetings. Additionally, the Journal includes abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese, and Spanish translations - making news of advances in the field available to pediatric and neonatal intensive care practitioners worldwide.
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